title: Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002-2011: a case series.
abstract: Visceral leishmaniasis (VL) is endemic in Northwest and southern Iran. Reports of cutaneous leishmaniasis (CL) in Northwest areas are rare, and its etiological agents are unknown. In the current study, we report six CL and two post kala-azar dermal leishmaniasis (PKDL) cases caused by Leishmania infantum from endemic areas of VL in the Northwest. Smears were made from skin lesions of 30 suspected patients in 2002-2011, and CL was determined by microscopy or culture. Leishmania spp. were identified by nested-PCR assay. The disease was confirmed in 20 out of 30 (66%) suspected patients by parasitological examinations. L. infantum was identified in eight and Leishmania major in 12 CL cases by nested-PCR. Cutaneous leishmaniasis patients infected with L. major had the history of travel to CL endemic areas. L. infantum antibodies were detected by direct agglutination test (DAT) at titers of 1:3200 in two cases with history of VL. Results of this study indicated that L. infantum is a causative agent of CL as well as PKDL in the VL endemic areas.
authors.affiliation: Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Badirzadeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohebali
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Ghasemian
authors.forename: Hassan
authors.initials: H
authors.lastname: Amini
authors.forename: Zabiholah
authors.initials: Z
authors.lastname: Zarei
authors.forename: Behnaz
authors.initials: B
authors.lastname: Akhoundi
authors.forename: Homa
authors.initials: H
authors.lastname: Hajjaran
authors.forename: Dariush
authors.initials: D
authors.lastname: Emdadi
authors.forename: Soheila
authors.initials: S
authors.lastname: Molaei
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kusha
authors.forename: Saber
authors.initials: S
authors.lastname: Alizadeh
mesh_terms: D000372:Agglutination Tests / Q000379:methods; D000913:Antibodies, Protozoan / Q000097:blood; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D018314:Leishmania infantum / Q000302:isolation & purification*; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D008853:Microscopy / Q000379:methods; D010274:Parasitology / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D012867:Skin / Q000469:parasitology / Q000473:pathology
chemical_list: D000913:Antibodies, Protozoan